Key insights and data direct from health plans reveal the following market access analysis of the respiratory market basket in our most recent Reality Check. For the full piece piece, click here.
Payer Coverage: A review of market access for asthma and COPD treatments shows that payers implement reimbursement restrictions for nearly one-third of U.S. lives.
Source: MMIT data as of Q1 2016
Trends: A recent report highlights some key prescribing contraints that HCPs face at the point of care. Market barriers include pricing, reimbursement restrictions, guidelines and patient preferences. Healthcare stakeholders focus their attention on rising patient costs for asthma and COPD treatments. Research reveals that many COPD patients lack the information needed to make an appropriate decision when choosing a health plan that offers affordable COPD medications and asthma treatment, while also aligning to their COPD symptoms and circumstances.
Key Findings: The prevalence of prior authorizations and step therapies create a complex market access landscape for the respiratory market basket. Novel therapies, targeting components of the anti-inflammatory pathway, will likely have well-defined roles in asthma treatment and management. Respiratory treatments pivot to include day-to-day symptom control and quality of life in addition to severe case management. From a segmentation perspective, product delivery greatly influences direct competition within the respiratory market basket.
In the full Reality Check on asthma and COPD below, MMIT's team of experts takes a deeper look into the clinical characteristics, drug market access and payer coverage to summarize key findings within the class.